can highlight, for example, positive examples of primary care provision such as
Airedale Hospital and Royal Free Hospital in London (see section 4.3). Fostering
cross sector understanding is critical to bring about a shift in health and care
services towards self-care and prevention.
We welcome Monitor's new guidance which will help patients receive more
joined-up care. A core principle of this new guidance is that NHS providers
should work effectively with other health and social care organisations locally
in order to identify and improve ways of delivering person-centred, coordinated
care for patients. For the first time NHS providers could lose their licence if they
are seen to block the delivery of integrated care when it can benefit patients. The
guidance also states that if NHS providers must 1) work with commissioners to
with commissioners to identify better coordination of services, 2) discuss shared
care plans for patients, or 3) avoid unnecessary delays in the handover of patient
records. Failure on any of these grounds will lead them liable to action from the
We also support Demos' recommendation in their 'Commission on Residential
Care' report that the Government should sponsor grants to stimulate innovation
in the housing with care sector to make it "more personalised, more connected
and more preventative" by increasing wellbeing, reducing unnecessary hospital
admissions and helping people to stay in their own homes.127
Recommendation: Fast track a practical and NHS-focused What
Works Centre for Integration, building on the strengths of existing
organisations, staffed by national health, GP and council policy
professionals (maintaining tri-partite approach).
Impact: This would:
• Tackle the perceived shortfall in step down care.
• Improve the communication and culture differences between health and
social care providers.
• Better the co-ordination of local services.
4.9 National leadership - Introducing a Minister for Older
Despite repeated public acknowledgement of the potency of the demographic
change we are experiencing, and the scale of the concomitant challenge that
the country faces, it is revealing that our survey found that 85 per cent of health
practitioners felt that the health and social care aspects of ageing are not
sufficiently well understood in the corridors of Westminster and Whitehall. We
believe this is because cross-cutting issues like ageing are all too easily lost in the
cracks between Government Departments.
Therefore we propose the introduction of a Minister for Older People. But not just
a title, this needs to be a post with the power to influence policy. The key point
here is that it is cross departmental so as to reach beyond existing silos and make
things happen. This reform would be cost neutral as we are not advocating the
creation of a new ministry but instead to expand the remit of a current Secretary
of State to include the post.
In addition to this, taking on board the concerns of local health leaders, NHS
England and Public Health England need to consider when and where leadership
and guidance is appropriate… The view of several Directors of Public Health
was that national leadership bodies "need to take a back seat." Longer term,
126 Monitor, "Monitor guidance
to help patients receive more
joined-up care" (14 January
127 Demos, Commission on
residential care (2014)